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Purpose: To evaluate the correlation of Meiboscale with symptom score (Ocular Surface Disease Index [OSDI]) and meibomian gland dysfunction (MGD) sign score. Methods: We performed a cross?sectional hospital?based study of 53 patients of primary MGD who filled the OSDI questionnaire form and underwent complete ocular examination. The MGD sign score was calculated in both eyes using the sum of six grading systems proposed by Arita et al. in 2016. The participants underwent imaging of the upper and lower eyelids of both eyes (212 eyelids) by specular microscope. The area of meibomian gland loss (MGL) was visually assessed and scored using the Meiboscale photographic card. Correlation between these three values – OSDI score, sign score, and MGL score based on Meiboscale ? was calculated using Spearman’s correlation analysis and Jonckheere– Terpstra (J–T) test. Correlation coefficient rs > 0.5 was considered clinically significant. Results: Associations between MGL score and OSDI score, as well as between OSDI and sign score were statistically significant, but not clinically significant (rs = 0.3684, P < 0.001 and rs = 0.41179, P < 0.001, respectively). The association between MGL score and MGD sign score was statistically as well as clinically significant (rs = 0.8392, P < 0.001). J–T test revealed large effect size (P < 0.001, r?effect = 0.93). Conclusion: The Meiboscale card had not been tested for utility in the Indian outpatient setting yet. Meiboscale can be used for reliable assessment and grading of MGD, and has clinical utility similar to the sum of six MGD sign scores. Additionally, assessment of symptoms using OSDI or a similar questionnaire is also recommended.
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Purpose: To study the effect of refractive errors on pattern visual evoked potential (VEP) recordings in the pediatric population. Methods: This cross?sectional observational study assessed 240 eyes of 120 participants attending the outpatient department of a tertiary care center in North India. Participants were between 8 and 18 years of age; 30 participants each were recruited into four groups, namely emmetropia, myopia, hypermetropia, and amblyopia. They were then subjected to pattern reversal VEP, with P?100 amplitude and latency recorded for each participant. Results: The emmetropic group in this study provided normal values of P?100 parameters, namely P?100 latency and P?100 amplitude with readings of 115.78 ± 10.19 ms and 11.11 ± 4.08 ?V, respectively. P?100 amplitude was significant compared to P?100 latency in detecting the presence or absence of a specific type of refractive error. It was found that there was a significant association between severity of myopia and P?100 latency (both unaided and aided) with P < 0.05. The severity of hypermetropia showed a significant association with P?100 amplitude (unaided) (P < 0.05). Receiver operating characteristics analysis revealed P?100 amplitude to be a good predictor of refractive error and the cut?offs were calculated. Conclusion: The P?100 parameters of the pediatric Indian population were comparatively higher than conventional values. P?100 latency seemed to better correlate with myopia, while hypermetropia correlated with P?100 amplitude. P?100 amplitude appears to be the most significant predictor of the presence of refractive error in an individual.
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Purpose: To estimate prevalence of common ocular morbidities including color blindness among school?attending children of an urban foothill town of Uttarakhand State in Northern India. Methods: A cross?sectional study was conducted among school?going children of age group 6–16 years of standard I– XII. Schools were selected using population proportionate to the size sampling technique. Detailed ocular examination including color vision and unaided or aided visual acuity for various ocular morbidities was done. Data was entered into MS excel with statistical analysis using SPSS version 23 with significant P value <0.05. Results: In total, 13,492 students (mean age 10.9 ± 2.7 years) with almost equal male to female ratio were screened. Overall prevalence of ocular morbidity was 23.2%, with refractive error (18.5%) on top, followed by color blindness (2.2%). The later was observed more among males (3.0%) as compared to females (1.4%) with significantly higher odds, OR = 2.3 (1.7–2.9) (P < 0.001). Conclusion: Refractive error has been the most common ocular morbidity, followed by color blindness. Earliest detection can prevent permanent disability and disappointment among youngsters when rejected from entering certain professions due to color vision defect
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Background: To assess the role of intravitreal bevacizumab (1.25 mg) in patients with proliferative diabetic retinopathy with macular edema in terms of change in leakage area and best-corrected visual acuity.Methods: This prospective randomized interventional study was conducted in the Department of Ophthalmology from September 2013 to August 2015 and included thirty eyes of twenty patients.After a detailed history and ocular examination, diagnosed cases of proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) underwent sequential fundus fluorescein angiography. Bevacizumab was administered intravitreally. Patients were assessed two hours after injection for anterior chamber reaction and intraocular pressure and were advised follow-ups at 24 hours and then at 1, 4, 8 and 12 weeks. For the outcome, the change of retinal new vessels by assessment of leakage area using Quantitative Planimetric Analysis (QPA) of photographs as well as the change in best-corrected visual acuity (BCVA) from baseline to the 12 weeks follow-up, were done. Results were analyzed statistically by applying t-test.Results: Intravitreal bevacizumab injection lead to a significant decrease in leakage in DME and PDR, and improvement in mean BCVA. The effect was maximum at 4 weeks which weaned off as the study progressed through it remains statistically significant at the end of 12 weeks.Conclusions: Intravitreal bevacizumab plays a major role in treating and reducing visual deterioration in patients with proliferative diabetic retinopathy and diabetic macular edema.
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Purpose: The study aimed to compare the effect of different materials, thicknesses, and polymerization methods and cycles, on the surface porosity of acrylic denture base resins. Materials and Methods: Conventional heat-polymerized polymethyl methacrylate (PMMA) and specially designed acrylic resin (Acron MC) were used to make 84 rectangular samples. They were divided into three groups to evaluate and compare the polymerization techniques, curing cycles, and thicknesses of the two denture base materials (28 samples each). Group A contained PMMA samples polymerized using water bath method (control group); Group B contained Acron MC samples polymerized by microwave method, and Group C contained PMMA samples polymerized by microwave method. Each group was further divided based on sample thickness and polymerization cycles. Each sample was scanned for surface porosity and area of each pore was measured using optical microscope. Data was analyzed using ANOVA, Bonferroni, and student t-tests. Unpaired student t-test was performed to compare the means of surface porosity with polymerization cycles and thicknesses among the groups. The power of study was kept at 80%. Results: Group C showed highest mean % of porosity depending on method of polymerization, different polymerization cycles (short and long) and polymerization cycles within the group. Group B showed the highest mean % of porosity depending on thickness and thickness within the groups. Conclusions: Microwavable acrylic resin polymerized by microwave energy exhibited statistically insignificant increase in porosity when compared to conventional heat cured acrylic resin by water bath method. Conventional acrylic resin polymerized by microwave energy exhibited high statistically significant porosity irrespective of sample thickness. There was statistically insignificant increase in porosity depending on sample thickness irrespective of material and method of polymerization.
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The hinge axis is an imaginary line around which the condyles can rotate without translation. Terminal hinge position is the most retruded hinge position and it is significant because it is a learnable, repeatable and recordable position that coincides with the position of centric relation. There are many schools of thought regarding hinge axis. The proponents of Gnathology say that there is one transverse hinge axis common to both condyles which can be accurately located. The proponents of transographics claim that each condyle has a different transverse hinge axis and that a transograph is the only instrument that can duplicate this. Still others claim that an exact duplication of jaw movement is not possible on any machine. The aim of this article is to throw light on location, clinical use and controversies of hinge axis.
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Background: Dry eye produces discomfort and reduced vision. The treatment of dry eyes has traditionally involved hydrating and lubricating artifi cial tears. The newer medications include non-steroidal anti-infl ammatory drugs (NSAIDs) for the treatment of dry eye disorders. This study was designed to compare the effect of topical carboxymethylcellulose (CMC) alone or in combination with topical NSAID for the treatment of dry eye in a tertiary care teaching hospital. Methods: A total of 60 patients diagnosed with dry eye were enrolled for a study period of 1 year. Patient of either sex (male/female), age between 18 and 70 years, and all diagnosed cases of dry eye in ophthalmology outpatient department were selected. Patients (n=60) were stabilized on CMC for 2 weeks and thereafter divided into two groups. Group I (n=30) received only topical CMC; Group II (n=30) received CMC+NSAID. The patients were followed up to 12 weeks. Diagnostic tests included Schirmer’s test and tear break up time (TBUT). Ocular Surface Disease Index (OSDI) was used for assessing the Quality of Life. Analysis was done using GraphPad InStat software. p<0.05 was considered signifi cant. Results: This was an open-label study revealing a mean age of 46.0±1.79 years. Females (56.67%) showed a signifi cantly higher prevalence of dry eye symptoms compared to males (43.33%). The mean duration of illness was 1.95±0.16 years. Schirmer’s test, TBUT test values and OSDI score in Group I and Group II at 0 and 12 weeks revealed signifi cant intragroup difference (p<0.0001). At 12 weeks intergroup comparison in Schirmer’s test value (p>0.05) and TBUT test value (p>0.05) showed no signifi cant difference while OSDI score revealed signifi cant difference (p<0.05). Burning, stinging, blurring of vision, photophobia, and hyperemia were among the common adverse effects seen. Conclusion: Both groups showed signifi cant improvement in Schirmer’s test and TBUT test value and OSDI score at the end of the study. Intergroup comparison showed a signifi cant difference with reference to OSDI score. Patients receiving NSAID reported more adverse effects.
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Background: Irrational prescribing is a common phenomenon, seen among medical practitioners. Knowledge, awareness, and attitude denote the practicing trends among the practitioners. The objective of this study was to describe the prescribing practices in Ophthalmology outpatient department (OPD) to promote rational prescribing. Methods: This study was conducted between January 2011 to June 2011, in Department of Pharmacology and Ophthalmology, SGRRIM and HS, Dehradun, Uttarakhand. A total number of 255 prescriptions were randomly collected from the Ophthalmology OPD and were analyzed for various parameters using national essential medicine list 2011 and World Health Organization drug use indicators. Results: A total number of 255 prescriptions were evaluated for prescribing pattern, 153 (60%) patients were between 16 and 45 years of age, the male: female ratio was 1.13:1. 237 (93%) patients from middle socioeconomic status. Diseases pattern observed were conjunctivitis 102 (40%), refractive error 45 (17.64%), stye 12 (4.7%), cataract 9 (3.52%), and miscellaneous 87 (34.12%). One hundred and thirty-eight (54.11%) patients received antimicrobial agents, fluoroquinolone (ofloxacin, moxifloxacin, gatifloxacin, etc.) were the most frequently prescribed antimicrobial drugs, analgesics (diclofenac and ketorolac) were prescribed to 45 (17.64%) patients, 54 (21.17%) received steroids (dexamethasone and prednisolone), 96 (37.64%) patients received other drugs (carboxymethylcellulose [CMC], multi-vitamins, zinc preparations, acyclovir, and anti-allergics). Fixed dose combinations (FDCs) were used in 90 (35.29%) patients, the most common combination was antimicrobials with steroids. All the drugs were prescribed by brand names and 1.9 drug/prescription was used. Conclusion: Topical antimicrobial agents are the most commonly used drugs in ophthalmic OPD in our setup; the most common FDCs prescribed were antimicrobials with steroids, the other commonly used drugs were analgesics, CMC and anti-allergic drugs.
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Human beings are able to perceive hundreds of shades of color which depends on the three types of cone system and various ratios of stimulation in response to different wavelengths. Perceptually and cognitively, men and women may experience appearance of color differently. Therefore, this study was planned to assess and compare color vision in male and female subjects. This study was carried out in the department of Physiology, SGRRIM&HS, Dehradun on 60 ocular healthy subjects (equal number of males and females) of 17–22 years of age group. The task was to match 22 test color strips with 2 shade charts of different colors. Total number of correct answers and total time taken in matching all the test color strips with the shade charts was recorded in both the sexes and analyzed. The results of this study showed that overall, females gave more correct responses (P<0.001) and also took less time (P<0.01) than males. Color wise also, females gave more correct responses especially for red (P<.001) and green color (P<0.01). The conclusion states that the females can see more shades of colors than males.
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We report a case where bilateral drusen of the optic nerve head was found in association with Goldenhar syndrome and which, to the best of our knowledge, is the only report of its kind.
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It is a long-accepted dogma in ophthalmology that the lens is a tumour-free tissue. Yet, in the lens, there is lifelong mitotic activity in the subcapsular epithelium. Therefore, these subcapsular epithelial cells must have the potential for cellular transformation. How then can we explain the fact that no scientist has ever seen a naturally occurring primary tumour of the lens in vivo? This review discusses the early work of Mann, von Hallermann, Courtois and others who addressed the issue of tumour resistance of the lens.